I’m going to attempt to describe what it’s like to go through cataract surgery and be as detailed as possible.  Most people seem to just have the surgery and tell others “Yeah, I can see great!”  I’ve talked to some of these folks and when you dig hard, I’ve found that their vision was not so great at first and that it took about two weeks to return to normal.  So I have to conclude that most people try to put it all behind them and talk in vague generalities.
Well, I’m going to try and remember everything.  Plus, I read some personal testimonials at various websites and a large number of those are poorly written or obviously written by somebody who had a bad experience and was angry about it.  Lots of posts were written in all-caps; I always discount those.  Nothing was terribly useful to me so here is my experience.
I got an IOL called the “Tecnis Multifocal”.  There are several different models but I don’t know what the differences are.  I have a wallet card that I’m supposed to carry for some reason but it says that the prescription is about +20 diopters.  The diopter is the reciprocal of the focal length of the lens.  I’ve always wondered why optometrists use the term diopter rather than focal length like the rest of the optics world.  If one is the reciprocal of the other it seems that one would be as useful as the other. I’ve since learned that you can get contact lenses like this.
Right after the surgery, things were simply blurry – simply out of focus like what you see if you look through binoculars that aren’t focused yet.  After a few days, things were still blurry but seemed to be more focused.  At that point I could discern another aberration: around most images I could see six other images slightly offset from the real one.  They are faint but they are there.  These are mostly noticeable at night when looking at lights such as streetlights, traffic lights, oncoming cars, etc.  The aberrations aren’t all that distracting but they’re noticeable and generally contribute to the feeling that the eyes aren’t yet working right.  This effect has subsided with time.  I think this must be the “halo” that the literature describes.  I’m not sure If these ‘extra’ images are due to astigmatism or some other effect.  It will be interesting to see if they eventually go away.  I suspect they will not since one of the things I read somewhere mentioned that these IOLs are not recommended for truck drivers or anybody who drives a lot at night.  Another interesting aberration is that some lights (not sure which type – they almost always are bluish and I see them in parking lots) have many concentric rings around them.  More rings that my lenses have.
Up close is interesting.  There is a point at 12” away from my face (I measured it) where everything comes into sharp focus.  This was pretty blurry at first but was apparently due to the general blurriness I described above.  The image is pretty sharp but does seem to be a bit diffuse at the edges of sharply defined letters and numbers.  Photographs of things with lots of small things like leaves on trees seem to be never quite in sharp focus although I can definitely see what they are.  Printed text is easier to read than things like computer monitors that illuminate themselves.
The region in between 12 inches and about 10 feet is pretty blurry.  The surgeon says that with time, all this area will come into sharper focus and then the healing will be complete.  Or more like the brain training will be complete.
It’s interesting to try and study the images up close.  If I concentrate on a text document on the computer, some blurriness around the edges of things seems to come and go.  I don’t know if this sort of thing always occurs even in healthy eyes and you just don’t notice it or if this is my brain training itself to ignore things that are not known characters or to ignore a secondary image coming from the other focal point.  I think some of this may still be due to the other aberrations that are working themselves out because I can use a magnifying lens and get things into nice sharp focus.
I can at times see the rings in the lens or perhaps it is the shadow of the rings.  I notice that if there is a light source above my head, sometimes there will be a glint off my eyelashes and this point source that is very close to my eye will show me a pattern of rings which exactly matches that of the IOL.  I can reproduce this by sitting near an off=axis light source (such as sunlight through a window) and holding a length of ball-chain up very near to my eye (at about eyelash distance).  The glints from the little balls will each produce an image of rings that exactly match the diagram of the Tecnis that I downloaded from Abbot’s website.  Again, this is pretty rare and is not distracting but it is interesting.
Wednesday: Can read tail number perfectly on the left – can’t really make it out on the right.
Thursday: Tail number on A/C across taxiway is perfectly sharp on the left.  Can barely make it out on the right.
Friday 17 February 2012: Noticeably better as it is every day.  Again, left eye normal at infinity, right eye slightly blurry.  Traffic lights still with multiple ghost images but they seem closer to the real image today.  Merged with the real image so that I can only see half the ghost – unlike earlier in the week where I could see six individual ghost images around the center (real) image of the traffic light.  Today, streetlights have multiple faint halos – maybe three or four. Other lights do not. One porchlight in my neighborhood generates a nice ring pattern but only that one light.  Today, I can read the tail number off the plane across the taxiway perfectly with the left eye – I can easily make it out with the right but it isn’t sharp.  Also ocular migraine this morning – sometimes called a migraine aura or scintillating scotoma.  That brings the total to four altogether.  I can’t seem to correlate them to anything that might cause them.
Monday 5 March 2012: Just got back from two weeks in Greenville.  I had to just go on as normal and stop analyzing my own vision since I had to drive a lot and them work at a variety of distances.  While talking about it at work, I was accused of overthinking things and this may be a valid comment.  I should probably just get on with life and let my brain train itself.  Still, I’m back at it now.
Working in the optics lab, I went and got a pinhole.  It was the smallest I could find in the monochromator’s set (.25 mm).  I held this up to my eye until my eyelashes were touching it and put a flashlight right up to it.  This has the effect of allowing you to see things like floaters in your eye and, in my case, the lens implant itself and its concentric rings.  Pretty cool actually.  Nothing else of interest though.
At this point, I feel my left eye is back to normal at distances.  The right is still not in focus and I don’t think it will get there.  I downloaded an iPhone app that measures visual acuity and it still says I’m 20/20 in the left and 20/25 on the right.
Right before I left on my trip, I had a visit to the opthalmologist’s (the surgeon actually) and this is what he measured my acuity at.  Visual acuity is not everything though.  You can be tested at some value and still not think you can see as well as you used to.  I’m not sure how that translates into something you can test though.  The iPhone app seems to indicate that I have some astigmatism in my right eye.  This can be corrected and apparently is included in my treatment plan.  He also said I have the beginnings of a capsular cataract which is a common occurance after cataract surgery where some gunk condenses on the rear surface of the lens capsule.  This can be treated quickly with a laser and will be done – probably in May when my next appointment is.  He wants me to wait this long for everything to stabilize before deciding what to do next.  I can’t wait.
Finally, looking at computer monitors is still the hardest.  Oddly, when I first sit down, everything is blurry at the standard 18 inch distance but if I just look and try to read, the characters soon become focused.  If I move my head at all, the image goes blurry again and I have to concentrate awhile to make it focus again. I’m not sure why that happens except that the brain is most likely doing something cool.  At the last appointment, the surgeon again told me pointedly to just get on with life and not to give up and buy those “cheater” glasses at Walgreen’s.  I need to give the brain time to deal with its inputs.
Night driving is pretty annoying though.  Every light has either rings, a blur of blobs around it or it looks like a star with radiating lines coming from it.  Plus for lights that are off to the side, there is an annoying internal reflection or something that turns into a large diffuse blob of light.  But I don’t drive at night that much so I can deal with that.

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